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ACOG Committee Opinion No. 362: Medical Futility

    Obstetrics and Gynecology
    |March 3, 2007
    PubMed

    Insights

    Physicians should establish clear institutional policies for medical futility conflicts, rather than making unilateral decisions. Patient and family values, including the priority of life, should guide treatment choices when disagreements arise.

    Area of Science:

    • Medical Ethics
    • Healthcare Policy
    • Clinical Decision-Making

    Background:

    • The concept of medical futility is often invoked to justify a physician's refusal to provide requested treatments.
    • This practice can lead to significant conflicts between healthcare providers, patients, and their families.

    Purpose of the Study:

    • To emphasize the importance of developing institutional processes for managing conflicts related to medical futility.
    • To advocate for proactive policies over individual physician discretion in futility disputes.

    Main Methods:

    • This study is a conceptual analysis and policy recommendation based on ethical and clinical considerations.
    • It reviews the implications of unilateral decision-making versus established institutional protocols.

    Main Results:

    • Prospective, standardized policies for addressing medical futility are superior to unilateral physician judgments.
    • Establishing clear institutional processes can mitigate conflict and ensure consistent care.

    Conclusions:

    • Healthcare institutions must develop and implement clear policies on medical futility.
    • In cases of disagreement, patient and family values, alongside the principle of preserving life, should be prioritized.

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